Nonvariceal upper gastrointestinal bleeding

Tina Park, Wahid Wassef

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

Purpose of review: Acute upper gastrointestinal bleeding is one of the most common medical emergencies. It is important to recognize potential etiologies of upper gastrointestinal bleeding and understand therapeutic modalities available in achieving hemostasis. This article summarizes guidelines in management of acute nonvariceal upper gastrointestinal bleeding and reviews recent advances in the field. Recent findings: Recent study showed that patients who received blood transfusion with threshold hemoglobin below 7 g/dl rather than below 9 g/dl had significantly lower mortality at 45 days. Endoscopic therapy should be performed on actively bleeding ulcers and ulcers with visible vessel or adherent clot. An over-the-scope clip is a novel device that can be used to achieve hemostasis. It may be a useful tool for achieving hemostasis for patients who failed endoscopic therapy with epinephrine injection, clip, or thermal therapy. Doppler ultrasound probe can evaluate arterial flow to the ulcer and identify ulcers that are at high risk of rebleeding. Summary: Upper gastrointestinal bleeding from peptic ulcer disease is not a new clinical problem. Yet, the approach to management continues to evolve with the accumulation of data and well designed studies on the subject.

Original languageEnglish (US)
Pages (from-to)603-608
Number of pages6
JournalCurrent Opinion in Gastroenterology
Volume30
Issue number6
DOIs
StatePublished - 2014
Externally publishedYes

Keywords

  • Over-the-scope clip
  • Peptic ulcer disease
  • Transfusion goals
  • Upper gastrointestinal bleeding

ASJC Scopus subject areas

  • Gastroenterology

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